Provider Demographics
NPI:1033926480
Name:TORRICO MEDICAL GROUP INC
Entity type:Organization
Organization Name:TORRICO MEDICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:J
Authorized Official - Last Name:TORRICO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-682-6148
Mailing Address - Street 1:1728 OCEAN AVENUE
Mailing Address - Street 2:PMB 140
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1737
Mailing Address - Country:US
Mailing Address - Phone:801-682-6148
Mailing Address - Fax:
Practice Address - Street 1:1287 FULTON RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4923
Practice Address - Country:US
Practice Address - Phone:707-800-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty